Asthma: Complications and Management

Overview

What is Asthma ?

Asthma is a Non-communicable but chronic disease of the respiratory system. It majorly affects our lungs. Lungs are the major organs for breathing air, they are connected with thin tube-like structures called bronchi and bronchiole, and together they make airways to the lungs. When due to some underlying reasons, an inflammation of the airways occurs and leads to the narrowing of airways, then it causes difficult in-out movement of air.

Asthma can trigger at any stage of life. An asthmatic person experiences continuous coughing and wheezing with other associated symptoms. At present there is no cure for asthma but, effective management is possible by developing the proper understanding. This article will help to get a basic understanding of the complications and management of asthma. ¹Overview | Researched based study from nih.gov

Symptoms

How to recognize the symptoms of Asthma?

Symptoms of asthma include,

• Chronic wheezing
• Chronic coughing
• Shortness of breath
• Breathlessness
• Unusual sound with breathing
• Tightness in chest
• Pain or pressure in the chest
• Difficulty in breathing

Sometimes people cannot differentiate between normal cough and asthma, but there are some major differences between the two,

• Unlike asthma, cough last for up to 8 weeks and goes away once the cold or allergy is treated

• In most cases, asthma-related cough is dry or minimal

• Cough can also be associated with other diseases like bronchitis, COPD, flu, etc. it is necessary to know the exact cause of cough.

Triggers

Triggering factors of Asthma

An asthma attack occurs when any substance causes inflammation of the airways and resists the normal movement of air. data suggests that some common triggers of an asthma attack are,

• Pollen grains
• Fumes
• Dust
• Flour
• Smoke
• Cold and dry air
• Pollutants
• Mites
• Molds
• Chemical sprays
• Perfumes
• Animal’s hair and excreta
• Pests
• Exercise
• Tobacco
• Pregnancy

Reasons

What are the reasons of an Asthma attack?

• Asthma attacks commonly appear in young kids with a family history of asthma.
• A person who has weak immunity is also more susceptible to developing asthma than others.
• Chronic respiratory infection and prolonged exposure to chemical fumes/irritants are also counted as the cause of asthma.
• In a few cases, work-related changes
• Pregnancy also lead to an asthma attack
• Children with low weight at birth also have a high chance of developing asthma.

Types

Types of Asthma

Asthma can be classified in various ways, and its identification is necessary to manage an asthma attack.

Based on the age of the patient, asthma can be

Pediatric asthma

• It is asthma in young kids, especially toddlers, and children between 5 to 15 years of age mainly suffer from this. Reasons can be genetic, low birth, stress, overactivity, etc.

Asthma in adults

• When the onset of asthma appears in adulthood, it is mostly understood as acquired asthma. And the main reason is work-related, obesity, allergies, etc.

Based on reasons

Allergic asthma

• When asthma triggers due to a few allergens like dust, mites, pollen, etc. It is easy to manage by avoiding contact with the allergen.

Non-allergic asthma

• Anxiety, stress, or disease can cause an asthma attack and is called non-allergic asthma.

When the intensity is measured, asthma can be

Mild asthma

• Asthma attacks are easy to manage with very few symptoms or discomfort and are characterized by coughing and wheezing.

Major asthma

• Medical attention is needed to treat asthma attacks, it affects the daily routine of life. And cause difficulty breathing with coughing and wheezing.

Severe asthma

• It’s a life-threatening condition where immediate medical assistance is mandatory to save a patient’s life. Identified by shortness of breath, pressure, or pain in the chest with or without coughing or wheezing.

Asthma can also be classified as, intermittent, persistent, seasonal, drug-induced asthma, etc. ²classification | Researched based study from nih.gov

Diagnosis

Diagnosis of Asthma

Diagnosis starts with the physical examination of a patient, the study of any history of asthma in the patient’s family, and the presence of any allergy. further, it involves some,

Specific kinds of test procedures mentioned below

• X-Ray of Chest
• Spirometry Test for Asthma
• Peak flow Test for Asthma
• FeNO Test for Asthma
• Blood test for asthma

Skin test for asthma

Allergic asthma is a common type of asthma. An IgE test is carried out to confirm the presence of allergic asthma. Skin test gives accurate information about the allergen that causes asthma attack in the patient. There are three main methods to perform the skin test,

• Prick test-All the possible allergens are pricked in small amounts to show the response of the body, and each test site is marked and then observed for positive or negative results.
• Patch test-In this method, the allergen under test is injected in a small amount and then the patient is observed for any reactions.
• Intradermal test-Patches of allergen are made and stuck to the skin of the patient to understand the allergen responsible for the asthmatic attack.

The doctor conducts several tests to know the reason behind asthma episodes and to ensure the effect of management and progress of the disease.

Complications

Complications related to Asthma

Episodes of asthma are related to several complications that affect the quality of life and hinder work and daily routine.

• Airway Remodeling-It is the process by which the body’s defense mechanism tries to heal the injured cells and tissue due to some disease. Complications associated with airway remodeling are increasing mucus secretions, inflammation in airways, coughing, and wheezing.

• Failure of the respiratory system-In the case of improper management of asthma swelling of airways can increase and causes respiratory failure.
• Drug interactions-Asthma patients receive many medicines, including steroids, which can cause drug reactions if not prescribed carefully. Similarly, some drugs like beta blockers, Aspirin, and a few NSAIDs,s also trigger the attack of asthma.
• Disturbance in sleep-Sleep disturbance is common in poorly managed asthma. The inability to breathe normally causes a lack of sleep during the night and increases daytime sleep. And lack of sleep again provokes asthma.
• Gastric issues-Acid reflux is a common problem in asthma patients. It is found that asthma triggers acid reflux and the content of the stomach can reach to lungs and causes gastric asthma.
• Weight gain-Steroids are the main culprit for this complication. Long-term use of steroids to manage asthma leads to an increase in hunger and also slows down the metabolic rate causing weight gain in asthma patients. It is also linked to low physical activity in asthma patients.
• Anxiety and depression-Asthma patients start feeling anxious and depressed due to the discomfort that arises from an asthma attack. It causes a lack of confidence and low self-esteem in asthmatics. Studies show encouragement and social acceptance decrease the morbidity due to asthma.
• Falling sick easily-The body continuously deals with allergens in asthmatic patients which is why asthmatics catch a cold and flu very easily than others.
• Low physical activity-Exercise is one of the common triggers for asthma doctors also advise light physical activities. Therefore weight gain and related issues are challenges for asthma patients.
• Less time in school and at work-Children and adults both need to break from their studies and work and it directly impacts their ability to perform sometimes.

Complications in asthma patients arise due to poor health management and social negligence but can be reduced by a good combination of medicines and social environment. ³complications | Researched based study from globalasthmareport.org

Management

Management of Asthma

Management of asthma involves medicines, diet, and complementary treatment of the patient.

Management by medicines

Asthma is the result of the immune response of our body, against inflammation in the airways, and restriction in the airways. drugs prescribed by doctors target the reasons for inflammation, the immune response of the body and the dilators to remove any resistance in the movement of air.

Steroids

• They are also called corticosteroids. Drugs from this category are prescribed when asthma in a patient is not under control by regular medicines. They act by reducing the inflammation of the airways. It can give in tablet or inhaler form.
• Potential negative effects include: Increase hunger, weak bones, and mood shifts and elevated blood pressure.

Anti-cholinergic

• They decrease mucus secretion and aid in the movement of air during breathing. Side effects occurs with this category are, dry moth, urinary retention, constipation, irregular or high heart rate, dilated pupil, bloating, etc.

Beta-agonists

• For the management of asthma medicines of this category are the first line of treatment .they act by relaxing the muscles of the airways to ease breathing, and drugs like epinephrine and albuterol are common names to get fast relief from asthma.
• Muscle cramps, headaches, High blood pressure, anxiety, cramps are the possible adverse effects.

Leukotriene modifiers

• A doctor can prescribe leukotriene modifiers, which can help decrease the constriction of airways and controls wheezing and coughing.
• They can be used frequently to lessen the number of asthma attacks.
• Adverse effects of Leukotriene modifiers include abdominal pain and pain in head.

Long-acting bronchodilators

• To provide prolonged relief in asthma patients long-acting bronchodilators are used, the drugs come from various groups of salts and help in relaxing muscles of air tubes and bronchioles to increase the flow of air. Formoterol and salmeterol are common active agents of this category.
• The side effects they produce are Nausea, vomiting, dizziness, and dry mouth.

Theophylline

• Theophylline is relatively a weaker bronchodilator that can use for both long-term and short-term management of asthma and is rarely prescribed by doctors. It may cause severe headache.

Other

An asthma attack can occur at any time to control its impact medicines are administered in two ways,

• Long-acting drugs-pills, injections, or liquids containing drugs like formoterol provide prolonged relief and recovery.

• Short-acting drugs- to terminate the attack and immediate rescue drugs like albuterol and levalbuterol are given in the form of inhalers and spacers.

Vaccination against all infectious diseases like Influenza, Flu also reduce any chances of worsening asthma

Diet

Diet in Asthma management

• Food that helps in alleviating inflammation, clearing mucus, provide good immunity can help in the management of asthma, however, there is no established guideline for food to follow.
• Vitamins like C, D, and E help alleviate the symptoms because of their antioxidant features.
• Food rich in omega-3 fatty acids, magnesium, and selenium also provides damage control against asthma.
• Studies have shown that people who eat low-processed food and a good amount of fresh food, vegetables, and fruits have comparatively lower chances of an asthma attack.

Alternatives

Alternative and complementary treatment

CAM therapy

• Besides medicines and food, there are several other ways to ease asthma like CAM therapy for asthma management and to support healthy living in asthmatics.

Herbs

• A Chinese herbal formula containing extract of Glycyrrhiza uralensis and Sophora flavescens can improve lung health when taken under the supervision of a physician.⁵alternative treatment| Researched based study from nih.gov

Acupuncture

• Acupuncture practices show improvement in patients when performed under the guidance of a professional.

Yoga

• Yoga and breathing exercise under a trained professional also improves the health of the lungs, but care should be used while performing any physical activity to avoid an asthma attack. ⁶alternative treatment | Researched based study from err.ersjournals.com

Ayurveda

• Ayurveda also explains a few techniques and herbs to aid the management of asthma-like massage with hot oil and a sip of herbal decoction to lose mucus and relax muscles, of the respiratory system.

Management of asthma can be effectively done by using essential medicines with complementary and alternative therapies under the supervision of healthcare professionals. such practices help in improving the quality of life in asthmatics.

Emergency

When to seek medical assistance

Despite following every prescription and treatment guideline, a person must maintain a notebook to note down the progress, challenges, and any changes in therapy, if they have any asthmatic patients in their family. And keep tracing a few signals when they should immediately call for medical assistance. If an asthmatic person shows,

• Symptoms of other respiratory disease
• Uncontrolled wheezing
• Shortness of breath, especially during nighttime
• Complaint of pressure or tightness in the chest
• Pulse rate drops
• Unable to speak
• Showing no response to quick-acting inhalers
• Fainting.

Avoid any threat to life; an emergency number and number of some medical assistants should be on your speed dial list.

Myths

Myths related to asthma

There are many misconceptions related to asthma, and it is necessary to know the correct information to manage life with asthma.

• Asthmatics should not get involved in physical activities like sports, but this is not true because many sports people have asthma, and they are doing well with proper care.
• Asthma is the result of pollution fact is, pollution is not the only reason, asthma can occur due to several other factors like family history.
• There is no connection between body weight and asthma. The fact is, there are related studies that support the idea that obese people have higher chances of suffering from asthma and that reducing weight helps reduce asthma symptoms.
• Asthma is easy to cure; it doesn’t have a cure but can be managed to improve symptoms.
• Inhalers are most effective in asthma, but it’s not true, inhalers can help to terminate the attack immediately and long-term medicines are proven to be more effective.
• Only alternative therapies are enough to treat asthma, but the fact is that alternative therapies can only help and cannot provide complete relief from the symptoms.
• Similarly, myths are that once a child grows, asthma will cure itself, but it is not true. Any trigger can provoke an asthma attack, even in adulthood. ⁷Myths related to asthma | Researched based study from uthct.edu
• Keeping ourselves aware and updated is the only way to deny myths and believe in facts.

Outlook

Outlook

Although asthma poses a serious risk to life and is accompanied by several obstacles and complexities, this fact should not be used to cast doubt on the quality of life for those who suffer from the condition. The right kind of assistance, awareness, and education can make life easier for asthmatics. Asthma episodes can be decreased with the use of necessary medications, complementary and alternative medicine, a healthy diet, and breathing exercises. Although attacks cannot be prevented or stopped, they can be postponed.